Towards Promotion of Community rewards to Volunteer Community Health Workers? Lessons from Experiences of Village Health Teams in Luwero, Uganda

In the debate regarding volunteer Community Health Workers (CHWs) some argue that lack of remuneration is exploitation while others caution that any promise to pay volunteers will decrease the volunteer spirit. In this paper we discuss the possibility of community rewards for CHWs. Ethnographic fieldwork that lasted 18 months utilised methods including participant observation, FGDs, in-depth interviews and key informant interviews to gain insight into the dynamic relationship between volunteer CHWs known as Village Health Teams (VHTs) and the community. Contextual transcription was done and data was thematically analysed. Findings show that community members are willing to reward volunteer CHWs with cash, material and symbolic rewards in appreciation for their help. Factors crucial for this gesture included: care and recognition of the VHTs’ work by medical staff, fulfilment of the promises made to the community by government and exemplary behaviour by CHWs. Therefore, effort should be made to facilitate volunteer CHWs to be seen as helpful to their communities. Especially, there needs to be a smooth operation at the intersection between the VHTs, local government and medical structures. Community rewards could be a more sustainable way of motivating CHWs while a solution to health personnel shortage is sought

Traditional birth attendants (TBAs) as potential agents in promoting male involvement in maternity preparedness: insights from a rural community in Uganda

BACKGROUND: Since the 1994 International Conference on Population and Development, male involvement in reproductive health issues has been advocated as a means to improve maternal and child health outcomes, but to date, health providers have failed to achieve successful male involvement in pregnancy care especially in rural and remote areas where majority of the underserved populations live. In an effort to enhance community participation in maternity care, TBAs were trained and equipped to ensure better care and quick referral. In 1997, after the advent of the World Health Organization’s Safe Motherhood initiative, the enthusiasm turned away from traditional birth attendants (TBAs). However, in many developing countries, and especially in rural areas, TBAs continue to play a significant role. This study explored the interaction between men and TBAs in shaping maternal healthcare in a rural Ugandan context. METHODS: This study employed ethnographic methods including participant observation, which took place in the process of everyday life activities of the respondents within the community; 12 focus group discussions, and 12 in-depth interviews with community members and key informants. Participants in this study were purposively selected to include TBAs, men, opinion leaders like village chairmen, and other key informants who had knowledge about the configuration of maternity services in the community. Data analysis was done inductively through an iterative process in which transcribed data was read to identify themes and codes were assigned to those themes. RESULTS: Contrary to the thinking that TBA services are utilized by women only, we found that men actively seek the services of TBAs and utilize them for their wives’ healthcare within the community. TBAs in turn sensitize men using both cultural and biomedical health knowledge, and become allies with women in influencing men to provide resources needed for maternity care. CONCLUSION: In this study area, men trust and have confidence in TBAs; closer collaboration with TBAs may provide a suitable platform through which communities can be sensitized and men actively brought on board in promoting maternal health services for women in rural communities

Assessment of exploited fish species in the Lake Edward System, East Africa

The unknown status of inland fish stocks hinders their sustainable management. Therefore, increasing stock status information is important for sustainable inland fisheries. Fisheries reference points were estimated for five exploited fish species (11 stocks) in the Lake Edward system, East Africa, which is one of the most productive inland water systems. The aim was to ascertain the status of the fisheries and establish reference points for effective management. The reference points were based on four linked stock assessment approaches for data‐limited fisheries. Estimates showed poor stock status with the stocks defined as either collapsed, recruitment impaired or overfished. However, higher catches could be obtained under sustainable management. Estimates of maximum sustainable yield (MSY) and supporting biomass (Bmsy) are provided for 10 of the stocks as targets for rebuilding plans. The immediate target of management should be rebuilding biomass to Bmsy. Applicable measures include shifting length at first capture to the length that maximizes catch without endangering size structure and biomass, and livelihood diversification out of fisheries

The Consequences of Anthropogenic Stressors on Cichlid Fish Communities: Revisiting Lakes Victoria, Kyoga, and Nabugabo

Lakes Victoria, Kyoga, and Nabugabo (“the Lake Victoria region”) are remarkable for hosting one of the largest assemblages of cichlid fishes among the African inland lakes. Here, we review the role and severity of anthropogenic and environmental stressors on the cichlid communities in the Lake Victoria region to understand the mechanisms leading to the persistence and resurgence of some of the cichlid fishes. Our review suggests that (1) the native Oreochromis species populations primarily collapsed due to overfishing and that the introduced species and habitat change suppressed their ability to recover; (2) without primary triggers associated with change in the environment and habitat conditions, particularly eutrophication and associated anoxia and reduced water transparency, Nile perch (Lates niloticus) predation alone may not have caused the massive loss of species diversity; and (3) the resurgence of haplochromine cichlids is due to a combination of general improvement in the environment and reduction in L. niloticus abundance, with additionally possibly some rapid ecological adaptations. We conclude that environmental stressors will likely continue to shape the ecosystems in which the remaining endemic cichlid fish diversity continue to evolve, clearly involving genetic exchange between species. If water clarity can be improved again, it is possible to maintain a diverse assemblage of endemic species

Ecosystem Models of Lake Victoria (East Africa): Exploring the Sensitivity of Ecosystem Effects of Fishing to Model Choice

Ecosystem simulation models are valuable tools for strengthening and promoting ecosystem-based fisheries management (EBFM). However, utility of these models in practical fisheries management is often undermined by lack of simple means to test the effect of uncertainty on model outputs. Recently, the use of multiple ecosystem models has been recommended as an ‘insurance’ against effects of uncertainty that comes with modelling complex systems. The assumption is that if models with different structure and formulation give consistent results, then, policy prescriptions are robust (i.e. less sensitive to model choice). However, information on the behaviour of trends from structurally-distinct ecosystem models with respect to changes in fishing conditions is limited, especially for freshwater systems. In this study, we compared outputs of two ecosystem models, Ecopath with Ecosim (EwE) and Atlantis, for Lake Victoria under different fishing pressure scenarios. We compared model behaviour at the ecosystem level, and also at a level of functional groups. At functional group level, we determined two questions: what is the change in the targeted group, and what are the consequent effects in other parts of the system? Overall results suggest that different model formulations can provide similar qualitative predictions (direction of change), especially for targeted groups with similar trophic interactions and adequate data for parameterization and calibration. However, considerable variations in predictions (where models predict opposite trends) may also occur due to inconsistencies in the strength of the aggregate multispecies interactions between species and models, and not necessarily due to model detail and complexity. Therefore, with more information and data, especially on diet, and comparable representation of feeding interactions across models, ecosystem models with distinct structure and formulation can give consistent policy evaluations for most biological groups

Ecosystem Modelling of Data-limited Fisheries: How Reliable are Ecopath with Ecosim Models without Historical Time Series Fitting?

Long-term time series data are not available for many of the African Great Lakes. This precludes fitting ecosystem model parameters to time series data, and we do not know how reliable non-fitted models are compared to fitted ones in terms of predicting consequences of alternative management strategies. To investigate this, we generate a historical Ecopath with Ecosim (EwE) model for Lake Victoria (East Africa), fitted to time series data (1980–2015), and a present-day EwE model (representing average conditions for the period 2010–2015). We do scenario simulations using the present-day model and the comparable 2015 end-state of the historical model, and test if incorporating information on short-term biomass trends by adjusting biomass accumulation (BA) parameter in the present-day model increases its reliability. We find that there are differences in model predictions, but those differences can be lessened by adjusting BA terms in the present-day model to reflect biomass trends from short-term empirical data. We also compare the models with and without fitted vulnerability parameters. The models generally give comparable results for the dominant commercial fisheries at low fishing pressure; when fishing mortality is increased, the models give variable predictions. This study adds to the current understanding of the limitations of EwE models that are not challenged to reproduce long-term historical fishery responses to perturbations. We conclude that for the less productive groups, as well as groups that suffer heavy mortality (either due to predation or fisheries), it may be appropriate to use negative BA as first draft assumption in present-day models

Simulating Trade-offs Between Socio-economic and Conservation Objectives for Lake Victoria (East Africa) Using Multispecies, Multifleet Ecosystem Models

Most small scale inland fisheries worldwide are open access, and fishing provides the only source of employment and livelihood for the riparian communities. Management of these fisheries requires information on trade-offs between fish production, profits from fishing, employment, and conservation objectives. We use the non-linear optimization procedure in Ecopath with Ecosim (EwE) modelling package to determine long-term, gear-specific fishing effort that can maximize economic, social, and conservation objectives for Lake Victoria (East Africa). Then, the resulting “optimal fishing effort” levels are applied in both EwE and Atlantis models to simulate long-term changes in the ecosystem. Results show profit maximization to be more compatible with conservation objectives than is the maximization of catch (or employment). However, maximizing economic value, while maintaining ecosystem structure, would require a reduction in fishing effort of almost every fishing gear. This trade-off can be severe (high social cost) for fishing communities with limited alternative livelihoods. This study provides an understanding of relative risks and benefits of various management objectives, which will enable stakeholders and the public to conduct informed discussions on future management policies

Ecosystem Models of Lake Victoria (East Africa): Exploring the Sensitivity of Ecosystem Effects of Fishing to Model Choice

Ecosystem simulation models are valuable tools for strengthening and promoting ecosystem-based fisheries management (EBFM). However, utility of these models in practical fisheries management is often undermined by lack of simple means to test the effect of uncertainty on model outputs. Recently, the use of multiple ecosystem models has been recommended as an ‘insurance’ against effects of uncertainty that comes with modelling complex systems. The assumption is that if models with different structure and formulation give consistent results, then, policy prescriptions are robust (i.e. less sensitive to model choice). However, information on the behaviour of trends from structurally-distinct ecosystem models with respect to changes in fishing conditions is limited, especially for freshwater systems. In this study, we compared outputs of two ecosystem models, Ecopath with Ecosim (EwE) and Atlantis, for Lake Victoria under different fishing pressure scenarios. We compared model behaviour at the ecosystem level, and also at a level of functional groups. At functional group level, we determined two questions: what is the change in the targeted group, and what are the consequent effects in other parts of the system? Overall results suggest that different model formulations can provide similar qualitative predictions (direction of change), especially for targeted groups with similar trophic interactions and adequate data for parameterization and calibration. However, considerable variations in predictions (where models predict opposite trends) may also occur due to inconsistencies in the strength of the aggregate multispecies interactions between species and models, and not necessarily due to model detail and complexity. Therefore, with more information and data, especially on diet, and comparable representation of feeding interactions across models, ecosystem models with distinct structure and formulation can give consistent policy evaluations for most biological groups